TRIAGE PROTOCOL

It is the policy of the TADMAT to attempt to provide the most good for the most people using limited resources. This shall be accomplished by the following procedure:

The Triage area operates under the direction of the Triage Officer within the Medical Section. All patients presenting to the operational area of the TADMAT shall:

1) Be assessed as soon as is possible under circumstances of the event. This assessment is to include:

• An immediate check of the primary life threats, which shall be managed as found.
• As thorough a security search as is possible, looking for weapons or other items posing a possible risk to TADMAT members or other patients.

2) Be categorized for further care and appropriate distribution into the TADMAT patient care system. The approved categories are:

A) RED: for those emergency patients with life threatening emergencies who will die or suffer permanent disability in less than one hour without immediate treatment and for whom management is practicable. These include:

1. Easily accessible hemorrhage
2. Correctable respiratory difficulty
3. Severe crushing injuries
4. Incomplete amputations
5. Severe lacerations with open fractures
6. Severe burns to face or airway
7. Second and third degree burns of <40%
8. Unconsciousness with unknown etiology
9. Symptoms indicative of a myocardial infarction
10. Status seizures
11. Pending or premature OB delivery
12. Severe poisonings by any route
13. Early to mid-stage shock

These shall be the highest priority for treatment. In addition if resources are sufficient, the following will be considered in this classification, otherwise, they will be considered expectant, and not managed until sufficient resources become available, at which time it is expected that they be re-triaged as appropriate.

The Medical Operations Chief will determine and notify personnel when the BLUE category will be utilized. Medical personnel shall be assigned to the blue area as necessary to prevent needless suffering of these patients:

• Non-traumatic cardiac arrest
• Profound hyperthermia
• Critical CNS injuries with coma/spinal cord injuries
• Severe burns > 40%
• Multiple critical injuries
• Traumatic asphyxia
• End stage hemorrhage/shock

B) YELLOW for those urgent patients whose problems may cause death or permanent disability in more than one hour but less than twelve hours and thus may receive delayed treatment. These include:

1. Simple fractures of major bones
2. Moderate lacerations without bleeding
3. Eye injuries
4. Non-critical CNS injuries without coma
5. Penetrating/perforating abdomen wounds without shock
6. Conscious diabetic states
7. Non-acute respiratory distress
8. Non-ambulatory medical illness

C) GREEN for minor injuries which are going to cause neither death nor permanent disability, thus requiring treatment without urgency. These are:

1. Small soft tissue injuries
2. Small, closed fractures
3. Minor, non-airway burns
4. Neuropsychiatric disorders
5. Obstetrical/gynecological disorders
6. Routine medical complaints
7. Out of medicine/compliance patients

D) BLACK is for the dead. They are to be treated respectfully, but receive no further attention until the living are managed.

• Be identified by placing both a completed triage tag and identification band around the patients wrist or attached to their clothing.
• Be logged into the TADMAT patient care system.
• Be transported to the appropriate patient care area according to their classification.

A) In order to maximize availability of personnel, only those truly non-ambulatory patients shall be stretcher borne.

B) Patients shall be removed from the triage area as soon as the above are complete. They shall only be held in the triage area upon the direction of the Medical Section Chief or designee, assumably due to overflow in subsequent areas.

C) It will be the responsibility of the treatment area to begin the full documentation of patient information and the management on the designated chart. The triage tag shall be kept with this chart as part of the permanent record.

D) Patient care areas will be established as above. However, their function may vary according to resources and mission. For Example:

• In a clearing and staging function, treatment areas will be designed to manage unstable patients and hold stable patients for transfer out of the area.
• In a triage or Pre-hospital function only, patients will be managed until evacuation to a more appropriate facility is available.